Prior Hypermobile Spinal Cord Stimulator Removal With Difficult Reimplantation due to Epidural Scarring Provides Relief in Postlaminectomy Syndrome.

BACKGROUND

When spinal cord stimulation (SCS) therapy fails for postlaminectomy syndrome (PLS), oftentimes the device is not removed or explanted, or rarely, it is reimplanted with the hopes of success with a new implant.

CASE REPORT: Our patient is a 52-year-old man with a history of PLS treated with L5-S1 discectomy who presented with refractory chronic low back pain. He underwent an initial SCS implant with significant pain relief, but was limited due to unwanted abdominal stimulations with movement and explanted 8 months later. Despite his prior experience, a second SCS was implanted but with great difficulty due to widespread epidural scarring leading to a positional headache, which self-resolved. Fortunately, the second implant provided > 50% pain relief.

CONCLUSIONS

Our case highlights the importance of reconsidering an SCS reimplantation which may benefit a select group of individuals, though more research is required to define this subset of patients.